Surgical instrument.



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Il IV `Il UNITED STATES PATENT OFFICE..

RICHARD II. SIMPSON, OF TURNERSVILLE, TEXAS.

SURGICAL INSTRUMENT.

SPECIFICATION forming part of Letters Patent No. 709,367, dated September 16, 1902.

Y Application liled November 29, 1901. Serial No. 84,095. (No model.)

To a/ZZ whom/ it muy concern/.f

Be it known that I, RICHARD H. SIMPSON, a citizen of the-United States, residing at Turnersville, Coryell county, State of Texas, have invented certain new and useful Improvements in Surgical Instru ments; and I do hereby declare the following to be a full, clear, and exact description of the invention, such as will enable others skilled in the art to which it ap- `pertains to make and use the same.

This invention relates to certain improvements in surgical imstruments, and relates more particularly to an instrument to aid or for use in performing the surgical operation knownras perineorrhaphia or operations of a somewhat similar nature where lacerated edges or the edges at a rupture are united by sutures; andthe objects and nature of my invention Will be obvious to those skilled in the art in the light of the following explanation of the accompanying drawings, which show,` merely as an example for purposes 'of illustration, a construction selected from among others within the spirit and scope of my invention.

My invention consists in certain novel features in construction and in combinations and arrangements of parts, as more 4fully and particularly pointedout and Specified hereinafter.

Referring to the accompanying drawings, Figure l is a perspective view of a form of instrument within the spirit andscope of my invention. Figs. 2 and3 are perspective views of the two blades of the instrument detached from eachother." Fig. 4 is an edge view or side elevation of the instrument as shown in Fig. 1. Fig. 5 is a'perspective view of the instrument, showing the sutures tied thereon as when in use, the dotted line indicating the lacerated edges of the Wound or rupture united and held together by the sutures and instrument. Fig. 6 isa sectional plan View of the instrument.

The broad object of my invention is to provide an instru ment orframework whereby the lacerated edges of a wound or-rupture can be brought accurately together by sutures and be thus held in position without strain or pressure until union is complete, whereupon the instrument can be easily removed without strain or injury to the parts.

The particularembodiment of my invention shown in the drawings is particularly intended'for use in treating or sewing up a lacerated perineum.

The specific form ot' instrument comprises a blade to enter the rectum and extend along opposite sides of the laceration in the rectal wall, a blade to enter the vagina and extend along opposite sides of the laceration. in the vaginal wall, and a connecting or other portion extending along the external perineum wall and along opposite sides of the laceration therein.

In the drawings, a is the rectal blade, which is shown extending at right angles from the body or connecting portion b, adapted to extend at the exterior of the body or perineum from the rectal blade to the vaginal blade c. The vaginal blade c is curved or segmental in shape, and any suitable clamp or connecting device is employed to detachably lock the vaginal blade to the body portion b. As a mere example, I show the outer end of the blade c provided with a` clamping jaw or member cl, rigid therewith and recessed at its outer face to receive the end of the body portion b, so that said member d can move longitudinally of the body portion b, together with blade c.

d is the opposing jaw or clamping member, arranged at the outer side of the body portion b and adapted to clamp said body portion against member d.

d" is a set-screw to lock the clamping members tightly together and against the body portion.

In the specific example shown the body portion and rectal blade form a single anglepiece, approximately a right-angled piece, bent from a single piece of metal wire doubled on itself to form the blade and body portion of separate lengths or parallel plies or sides. In the specific example shown the curved vaginal blade is also formed of a single doubled length of metal wire to form the two parallel separated sides or plies. I consider it important as at present advised that the blades have longitudinal openings, so that the lacerated meeting edges can be inspected and treated after the implement has been applied and so that the instrument will have portions extending along opposite sides of the meeting lacerated edges for the purpose hereinafter appearing.

e represents notches or grooves formed transversely in the opposite sides or lengths ot' each part of the instrument to receive andhold the sutures against slipping and to maintain the same in proper position.

Where a lacerated perineum is to be operated on, the sutures are inserted through the vaginal wall about three-eighths of an inch from thelacerated edge and passed in through the rectal wall about the same distance from the lacerated edge therein and then across the lacerated rectal wall and through the same about three-eighths of an inch on the other side of the lacerated edges from which the sutures entered the rectal wall and back through the vaginal wall on the opposite side of the laceration from where the sutures were first entered. The necessary number of sutures are inserted and passed through the vaginal and rectal Walls and left loose with long ends in the vagina. The rupture is then pressed apart and the curved blade is placed in the vagina and the other blade in the rectum between the sutures and the lacerated side of the wall. The blades ot' the instrument are then adjusted toward each other to the necessary positions to properly hold the parts, and the clamping device is locked to firmly hold the blades and body portion in the desired positions. The sutures f, Fig. 5, after the instrument has thus been inserted and properlyl adjusted with the sutures fitting in the grooves or notches, are properly tied. The body portion of the instrument rests and bears against the external wall of the perineum, and suturesfare passed through the said exterior wall, in at one side of the laceration and out at the other side and around the body portion of the instrument, and tied at the exterior, as indicated in Fig. 5. Also, if need be, certain sutures can be inserted through the vaginal wall and around the curved blade therein and through the exterior wall and around and tied over the body portion of theinstrument, as shown. It will be noted that the sutures on each side of the laceration pass over or across the opposite lengths of each portion of the instrument, so that the instrument, in effect, forms a framework on which the sutures are stretched and which takes the strain and relieves the body of the patient from the strain of the sutures. The instrument also clamps or holds the ruptured parts together'and against strain, as the instrument, in effect, forms a triangle between the three walls of which the ruptured perineum is held or clamped, While the longitudinal openings of the instrument expose the lacerated edges, so that they can be inspected and treated. After the lacerated edges have properly united the sutures are cut and removed, the connecting or clamping device of the instrument is loosened, and the body portion is removed, drawing the blade from the rectum,

ated edges are properly brought together and thus held without strain on the parts until union is complete.

The instrument can be made of well-plated steel of sufficient stiffness to prevent springing when the sutures are drawn over the same and tied.

Itis obvious that in accordance with my invention stiff open-Work frames can be employed to rest against a part of the body and around awound or rupture, so that the sutures can pass over the portions of the frame on opposite sides of the lacerated edges and receive the strain thereof when the sutures are tightened and tied to draw the lacerated edges together.

Having thus fully described my invention, what I claim as new, and desire to secure by Letters Patent of the United States, is-

1. A surgical instrument formed tocoperateiwith sutures in drawing and holding together the edges of a wound, rupture or laceration, and comprising a stiffopen suture-receiving frame formed to rest against the lacerated portion surrounding the cut and with the lacerated edges exposed in the opening of the frame, so that the sutures can be stretched transversely around the frame from oneside of the laceration to the other, for the purposes stated, the frame having transverse sutureholding notches along the outer edges of the opposite longitudinal portions.

2. In a device of the character described, the combination of a member having adjacent parallel angular portions; and a member having adjacent curved portions lying in parallel planes; the members being secured together at one extremity and inclosing a free open space substantially triangular in outline.

3. In a device of the character described, the combination of a memberhaving adjacent parallel angular portions; and a member having adjacent curved portions lying in parallel planes; the members being adjustably secured together at one extremity and inclosing a free open space substantially triangular in outline. v

4. In a device of the character described, the combination of a member having adjacent parallel angular portions; and a member having adjacent curved portions lying in parallel planes; the several portions having notches in their outer sides; the members being secured together at their extremities.

5. In a device of the character described, the combination of a member havingadjacent angular portions; and a member having adjacent curved portions; each of the curved portions lying in the same plane with one of IOO IIO

the angular portions; the members being seplane with one of the angular portions; the

cured together at one extremity and inclosing members being secured together at their exa free open space substantially triangular in tremities.

outline. In testimony whereof I affix my signature 6. In a device of the character described, in presence of two Witnesses.

the combination of a member having adjacent RICHARD H. SIMPSON.

parallel angular portions; and a member hav-4 Witnesses: ing adjacent portions lying in parallel planes; JOHN HOOPS, each of the curved portions lying in the same P. R. HOBIN. 

